Brain aging is often seen as inevitable, advancing steadily with age, but a newly published study suggests that years alone are not the determining factor. Researchers at the University of Florida found that optimism, consistent high-quality sleep and strong social ties are closely linked to healthier, younger-looking brains, up to eight years younger than a person’s chronological age.
The study followed 128 middle-aged and older adults, most of whom suffered from chronic musculoskeletal pain associated with, or posing a risk for, knee osteoarthritis. Chronic pain is known to contribute to accelerated brain aging. Over two years, researchers used MRI scans processed with a machine-learning model to estimate each participant’s “brain age” and compare it with their chronological age. The gap between the two, known as the “brain age gap,” served as a single measure of overall brain health.
“The researchers essentially found a metric that allowed them to look at the brain,” explained Dr. Majd Zaid, a senior neurologist at Assuta Ramat Hahayal Hospital. “Biologically, the most prominent feature of natural brain aging is a process called brain atrophy, a gradual loss of brain volume. It is usually most evident in two main lobes: the frontal lobe, responsible for planning and reasoning, and the temporal lobe, responsible for thinking and memory. In addition, there is thinning of the cortex, the brain’s outer layer, which is responsible for decision-making and attention, a process known as cortical thinning.”
According to Zaid, the study aimed to assess the relative contribution of chronic pain and socio-environmental risk, while also measuring behavioral and psychosocial factors. “This was an observational study of people aged 45 to 85, ages at which age-related brain changes begin to appear. The researchers wanted to see whether, beyond chronic pain, there were additional factors that could improve and preserve brain health, such as sleep, stress, social support, smoking and optimism," Zaid said.
Dr. Majd ZaidPhoto: Courtesy“After two years, they conducted another MRI assessment and found that chronic pain was not the strongest factor. Instead, lifestyle and psychosocial resilience played a larger role. People with better sleep, less stress and greater social support, who avoided smoking and maintained healthy physical measures, showed younger-looking brains, even if they suffered from persistent pain.”
Indeed, certain factors, including chronic pain, low income, limited education and social isolation, were associated with brains that appeared older. However, these links weakened over time. In contrast, maintaining a healthy lifestyle, including restorative sleep, healthy body weight, effective stress management, avoiding smoking and sustaining supportive relationships, was associated with younger-looking brains. Participants who reported the highest number of positive factors began the study with brains that appeared eight years younger than their actual age, and their rate of brain aging remained slower throughout the follow-up period.
Behind the scenes of brain aging
The findings raise a central question: how do lifestyle habits and psychosocial factors translate into measurable brain changes? “In general, as we age, the brain is exposed to many factors that lead to damage and diseases like Alzheimer’s,” explained Professor Naomi Habib, a brain researcher at the Edmond and Lily Safra Center for Brain Sciences at the Hebrew University. “But our habits, as shown across many studies, can influence this and tilt the balance toward healthy aging.
Professor Naomi HadidPhoto: Yonit Schiller“Some habits protect the brain, while others cause damage. This study specifically highlights factors related to how we cope with stress, sleep quality and social connections. Previous research shows that good sleep, balanced stress management and rich social relationships contribute to brain health. What is particularly interesting here is that maintaining optimism and a positive outlook on life is also linked to protecting the brain as we age.”
According to Zaid, the explanation lies in biochemical processes in the brain. “It all comes down to brain biochemistry,” he said. “When we experience higher quality of life, better sleep, less stress and more social support, the brain releases more endorphins and hormones that help preserve connections between neurons. This prevents aging and the development of neurodegenerative diseases such as Alzheimer’s and dementia, which involve destructive processes affecting brain neurons.”
Researchers have long known that aging brains are more vulnerable to cognitive decline, dementia and Alzheimer’s disease. Previous studies often focused on isolated brain regions, but pain, stress and major life events tend to affect broad neural networks. The current study reinforces these assumptions.
“There is extensive research on the impact of stress on the brain. We don’t fully understand why it accelerates brain aging, but we can hypothesize,” according to Habib. “During stress, the body releases substances such as cortisol that reach the brain and affect it. Blood flow patterns change, and the immune system weakens during negative stress, factors already known to influence brain health. When we are happy and calm, the opposite processes may occur.
“Social connection is another fascinating factor we still don’t fully understand in terms of brain aging, but it’s not surprising. We can feel its effect on our bodies when we are surrounded by a warm, loving environment with meaningful relationships. There is a very strong link between body and mind, or brain. We are not always aware of how much our emotional state affects our physical condition, and how our lifestyle influences brain health, but studies like this highlight that connection.”
Not just stress and social ties
While the study focuses mainly on emotional and social coping with stress, experts say it represents only part of a broader picture. Other lifestyle factors have long been known to significantly influence brain aging.
“In this study there was more emphasis on social and emotional aspects and stress coping, but the strongest factors we know that affect the brain, which were not the focus here, are usually physical activity and healthy, balanced nutrition,” Habib noted. “We know that physical activity is the number one factor linked to lifestyle, longevity and maintaining a healthy brain.”
Zaid added: “A daily walk of 30 to 40 minutes improves cerebral blood flow and memory. Strength training is linked to improved executive functions and reduced dementia risk. Morning exposure to daylight synchronizes the biological clock and improves alertness and attention.”
Cognitive activity also helps keep the brain healthy and young. “Learning something new, such as a language or a musical instrument, increases neuroplasticity and creates new synapses,” Zaid said. “Active reading strengthens working memory, abstract comprehension and frontal connectivity. Even thinking games like chess, sudoku or crosswords improve planning and cognitive flexibility.”
Perhaps more surprising is the link between healthy brain aging and oral hygiene. “In simple terms, brushing your teeth and maintaining healthy gums,” Habib said. “We still don’t fully understand why. It could be related to oral bacteria or to chronic inflammation in the body. Many studies show that oral health is a risk factor, so when we take care of our teeth and gums, we are also protecting the brain.”
Ultimately, while we cannot stop time, Zaid explained that the study offers an optimistic message: “Our brain responds to how we live, even at an older age and even if we live with chronic pain. Our daily choices may influence brain health more than we once thought.”